肌张力障碍姿势对颞叶内侧癫痫致痫区的定侧价值
Lateralizing value of dystonic posturing in patients with mesial temporal lobe epilepsy
摘要目的:探讨复杂部分发作(CPS)中上肢肌张力障碍姿势(DP)在药物难治性颞叶内侧癫痫( MTLE)致痫区定侧中的应用价值。方法对北京协和医院1997—2011年间89例MTLE并行手术治疗及术后长期随诊(≥2年)的患者术前发作录像进行回顾性的分析,重点关注DP出现时间及其与致痫区的侧别关系。结果在89例MTLE患者共424次CPS中,有37例(41.6%)患者的共92次CPS中出现了DP。绝大多数(92%) DP出现在发作中期,而不是发作的首发表现。 DP出现的对侧多提示为致痫区侧,其定侧致痫区的阳性预测值( PPV)为93.9%。结论在MTLE中,DP是一种可靠的定位体征,具有较高定侧致痫区价值。
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abstractsObjective To explore the lateralizing value of dystonic posturing ( DP) of upper limb in patients with refractory mesial temporal lobe epilepsy ( MTLE ) .Methods Presurgical videotypes of 89 patients staying seizure-free for at least 2 years after temporal lobectomy were retrospectively reviewed. Attention was paid to temporal correlation between occurrence of DP and seizure and the relationship of DP to side of epileptogenic zone ( resected side) .Results DP was observed in 92 complex partial seizure ( CPS) from 37(41.6%)patients among 89 patients with a total of 424 CPS.DP was not an initial symptom in the course of CPS and its onset occurred mostly in the middle third of ictus.DP displayed a high positive predictive value of 93.9% for lateralizing a contralateral seizure onset.Conclusion DP is a reliable lateralizing sign in patients with MTLE.
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